Continuity and Access in an Academic Family Medicine Center.
CONCLUSIONS: Despite multiple challenges in academic teaching practices, the continuous use of improvement methods to apply proven change concepts minimizes delay for care and maximizes continuity of care. The residency continuity practice can and should be a cornerstone of residency curriculum. PMID: 26950780 [PubMed - as supplied by publisher] (Source: Family Medicine)
Source: Family Medicine - March 8, 2016 Category: Primary Care Tags: Fam Med Source Type: research

"I Don't Want to Go Anywhere Else": Patient Experiences of Abortion in Family Medicine.
CONCLUSIONS: Women in our study reported high levels of satisfaction with care and would recommend this setting to others. In a context of increasing restrictions on abortion, family physicians are well-positioned to increase access by including abortion care in the range of reproductive health services offered in their primary care practice settings. PMID: 26950663 [PubMed - as supplied by publisher] (Source: Family Medicine)
Source: Family Medicine - March 8, 2016 Category: Primary Care Tags: Fam Med Source Type: research

Maximizing the Patient-Centered Medical Home (PCMH) by Choosing Words Wisely
Conclusions: Reworking well-established vernacular requires openness to change. True transformation does not, however, occur through a simple relabeling of old concepts. New terminology must represent values to which practices genuinely aspire, although caution is advised when using language to support cultural and clinical change. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2016 Category: Primary Care Authors: Howard, J., Etz, R. S., Crocker, J. B., Skinner, D., Kelleher, K. J., Hahn, K. A., Miller, W. L., Crabtree, B. F. Tags: Special Communication Source Type: research

Study: Primary care falling short on managing depression
Depression is one of the top chronic illnesses treated by primary care practices, but providers may be ill-equipped to manage it, compared with other conditions such as asthma, heart failure, and... (Source: Internal Medicine News)
Source: Internal Medicine News - March 7, 2016 Category: Internal Medicine Source Type: research

Care Management Processes Used Less Often For Depression Than For Other Chronic Conditions In US Primary Care Practices [Physicians]
Primary care physicians play an important role in the diagnosis and management of depression. Yet little is known about their use of care management processes for depression. Using national survey data for the period 2006–13, we assessed the use of five care management processes for depression and other chronic illnesses among primary care practices in the United States. We found significantly less use for depression than for asthma, congestive heart failure, or diabetes in 2012–13. On average, practices used fewer than one care management process for depression, and this level of use has not changed since 2006...
Source: Health Affairs - March 7, 2016 Category: Global & Universal Authors: Bishop, T. F., Ramsay, P. P., Casalino, L. P., Bao, Y., Pincus, H. A., Shortell, S. M. Tags: Mental Health/Substance Abuse, Chronic Care Physicians Source Type: research

Integrating Physical Activity in Primary Care Practice
Based on a collaborative symposium in 2014 hosted by the Society of Behavioral Medicine (SBM) and the American College of Sports Medicine (ACSM), this paper presents a model for physical activity counseling for primary care physicians (PCPs). Most United States adults do not meet national recommendations for physical activity levels. Socioecological factors drive differences in physical activity levels by geography, gender, age, and racial/ethnic group. The recent Patient Protection and Affordable Care Act (ACA) incentivizes PCPs to offer patients physical activity counseling. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - March 4, 2016 Category: Journals (General) Authors: Mona AuYoung, Sarah E. Linke, Sherry Pagoto, Matthew P. Buman, Lynette L. Craft, Caroline R. Richardson, Adrian Hutber, Bess H. Marcus, Paul Estabrooks, Sherri Sheinfeld Gorin Tags: Review Source Type: research

Integrating Physical Activity in Primary Care Practice
Based on a collaborative symposium in 2014 hosted by the Society of Behavioral Medicine (SBM) and the American College of Sports Medicine (ACSM), this paper presents a model for physical activity counseling for primary care physicians (PCPs). Most US adults do not meet national recommendations for physical activity levels. Socioecological factors drive differences in physical activity levels by geography, sex, age, and racial/ethnic group. The recent Patient Protection and Affordable Care Act incentivizes PCPs to offer patients physical activity counseling. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - March 4, 2016 Category: Journals (General) Authors: Mona AuYoung, Sarah E. Linke, Sherry Pagoto, Matthew P. Buman, Lynette L. Craft, Caroline R. Richardson, Adrian Hutber, Bess H. Marcus, Paul Estabrooks, Sherri Sheinfeld Gorin Tags: Review Source Type: research

Determinants of Health and Pediatric Primary Care Practices
More than 20% of children nationally live in poverty. Pediatric primary care practices are critical points-of-contact for these patients and their families. Practices must consider risks that are rooted in poverty as they determine how to best deliver family-centered care and move toward action on the social determinants of health. The Practice-Level Care Delivery Subgroup of the Academic Pediatric Association’s Task Force on Poverty has developed a roadmap for pediatric providers and practices to use as they adopt clinical practice redesign strategies aimed at mitigating poverty’s negative impact on child heal...
Source: PEDIATRICS - March 1, 2016 Category: Pediatrics Authors: Beck, A. F., Tschudy, M. M., Coker, T. R., Mistry, K. B., Cox, J. E., Gitterman, B. A., Chamberlain, L. J., Grace, A. M., Hole, M. K., Klass, P. E., Lobach, K. S., Ma, C. T., Navsaria, D., Northrip, K. D., Sadof, M. D., Shah, A. N., Fierman, A. H. Tags: Advocacy, Preventive Medicine Special Article Source Type: research

Improving HPV Vaccination Rates Using Maintenance-of-Certification Requirements
BACKGROUND: Many pediatricians are now required to participate in American Board of Pediatrics Maintenance of Certification (MOC) Part IV programs focused on improving health care quality, but the benefits of participation are unproven. METHODS: Twenty-seven primary care pediatricians from 11 primary care practices participated in a 1-year MOC program for human papillomavirus (HPV) vaccine. Participants received education and electronic health record (EHR)-generated performance feedback reports with their rates of captured HPV immunization opportunities (dose given at eligible visit) and those of peers. In each of 3 cycle...
Source: PEDIATRICS - March 1, 2016 Category: Pediatrics Authors: Fiks, A. G., Luan, X., Mayne, S. L. Tags: Administration/Practice Management, Quality Improvement, Infectious Disease, Vaccine/Immunization Quality Report Source Type: research

Organization Complexity and Primary Care Providers Perceptions of Quality Improvement Culture Within the Veterans Health Administration
This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers’ (PCPs’) perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohi...
Source: American Journal of Medical Quality - March 1, 2016 Category: Health Management Authors: Korom-Djakovic, D., Canamucio, A., Lempa, M., Yano, E. M., Long, J. A. Tags: Articles Source Type: research

Valuing primary care practice
I become more mindful every day of our educational and practice imperative in nursing to assure that our workforce is robust, well prepared, relevant, and timely. How educators and clinicians translate that to practice is often a complex cooperative approach to seek strategies that align education and practice priorities, assure that faculty and clinicians are current and competent in clinical and research skills, attend to trends in health systems, and engage in health policy. It's a tall order! My enthusiasm for our future in nursing is fueled by my knowledge that our Academy fellows are experts and leaders in these comp...
Source: Nursing Outlook - March 1, 2016 Category: Nursing Authors: Bobbie Berkowitz Tags: President's Message Source Type: research

Maximizing the Patient-Centered Medical Home (PCMH) by Choosing Words Wisely.
CONCLUSIONS: Reworking well-established vernacular requires openness to change. True transformation does not, however, occur through a simple relabeling of old concepts. New terminology must represent values to which practices genuinely aspire, although caution is advised when using language to support cultural and clinical change. PMID: 26957382 [PubMed - in process] (Source: American Family Physician)
Source: American Family Physician - March 1, 2016 Category: Primary Care Authors: Howard J, Etz RS, Crocker JB, Skinner D, Kelleher KJ, Hahn KA, Miller WL, Crabtree BF Tags: J Am Board Fam Med Source Type: research

Influence of Clinical Communication on Parents' Antibiotic Expectations for Children With Respiratory Tract Infections.
CONCLUSIONS: Clinician communication and prescribing behavior confirm parents' beliefs that antibiotics are needed to treat more severe illnesses. Interventions to reduce antibiotic expectations need to address communication within the consultation, prescribing behavior, and lay beliefs. PMID: 26951589 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 1, 2016 Category: Primary Care Authors: Cabral C, Ingram J, Lucas PJ, Redmond NM, Kai J, Hay AD, Horwood J Tags: Ann Fam Med Source Type: research

Practical Opportunities for Healthy Diet and Physical Activity: Relationship to Intentions, Behaviors, and Body Mass Index.
Abstract PURPOSE: Current strategies for improving diet and activity patterns focus on encouraging patients to make better choices, but they meet with limited success. Because the choices people make depend on the choices they have, we examined how practical opportunities for diet and physical activity shape behavioral intentions and achieved behaviors. METHODS: Participants included 746 adults who visited 8 large primary care practices in the Residency Research Network of Texas in 2012. We used structural equation models to confirm factor structures for a previously validated measure of practical opportuniti...
Source: Annals of Family Medicine - March 1, 2016 Category: Primary Care Authors: Ferrer RL, Burge SK, Palmer RF, Cruz I, RRNeT Investigators Tags: Ann Fam Med Source Type: research

Perspectives in Primary Care: A Conceptual Framework and Path for Integrating Social Determinants of Health Into Primary Care Practice.
PMID: 26951584 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 1, 2016 Category: Primary Care Authors: DeVoe JE, Bazemore AW, Cottrell EK, Likumahuwa-Ackman S, Grandmont J, Spach N, Gold R Tags: Ann Fam Med Source Type: research

Theory vs Practice: Should Primary Care Practice Take on Social Determinants of Health Now? No.
PMID: 26951583 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 1, 2016 Category: Primary Care Authors: Solberg LI Tags: Ann Fam Med Source Type: research

Theory vs Practice: Should Primary Care Practice Take on Social Determinants of Health Now? Yes.
PMID: 26951582 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 1, 2016 Category: Primary Care Authors: Kaufman A Tags: Ann Fam Med Source Type: research

Cognitive Impairment in Older Patients Receiving Care in an Urban Primary Care Practice
Introduction: The primary goal of this study was to determine the prevalence of patients screening positive for cognitive impairment in a low income, urban geriatric population. The second goal was to assess the prevalence of treatable mental health problems that could contribute to cognitive impairment. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - March 1, 2016 Category: Geriatrics Authors: Raisa Epistola, Jennifer Henry, Amy Holland, Olga Achildi, Mary Morrison Source Type: research

Chronic kidney disease in type 2 diabetic patients followed-up by primary care physicians in Switzerland: prevalence and prescription of antidiabetic drugs.
Abstract QUESTION UNDER STUDY: The aim of this study was to assess the prevalence of chronic kidney disease (CKD) among type 2 diabetic patients in primary care settings in Switzerland, and to analyse the prescription of antidiabetic drugs in CKD according to the prevailing recommendations. METHODS: In this cross-sectional study, each participating physician was asked to introduce anonymously in a web database the data from up to 15 consecutive diabetic patients attending her/his office between December 2013 and June 2014. Demographic, clinical and biochemical data were analysed. CKD was classified with the K...
Source: Swiss Medical Weekly - February 29, 2016 Category: Journals (General) Authors: Lamine F, Lalubin F, Pitteloud N, Burnier M, Zanchi A Tags: Swiss Med Wkly Source Type: research

Across the divide: “Primary care departments working together to redesign care to achieve the Triple Aim”
Conclusions Primary care in this large academic health center was transformed through developing a united primary care leadership team that bridged individual departments to create and adopt a common vision and solutions to shared problems. Our collaboration has achieved improvements across patient satisfaction, clinical safety metrics, and publicly-reported preventive care outcomes. Implications The description of this experience may be useful for other academic health centers or other non-integrated delivery systems undertaking primary care practice transformation. (Source: Healthcare)
Source: Healthcare - February 29, 2016 Category: Middle East Health Source Type: research

Effect of family medicine groups on visits to the emergency department among diabetic patients in Quebec between 2000 and 2011: a population-based segmented regression analysis
Family Medicine Groups (FMG) were introduced in Quebec in 2002 to re-organize primary care practices and encourage inter-professional service delivery. We measured visits to the emergency department (ED) for a... (Source: BMC Family Practice)
Source: BMC Family Practice - February 29, 2016 Category: Primary Care Authors: Renee Carter, Amélie Quesnel-Vallée, Céline Plante, Philippe Gamache and Jean-Frédéric Lévesque Source Type: research

Prescriber compliance with renal function monitoring in patients taking dabigatran (Pradaxa).
CONCLUSIONS: Over one-third of patients taking dabigatran for over a year did not have their renal function monitored in keeping with current guidelines, potentially leading to an increased risk of bleeding. We suggest there is a need for an automated reminder to prompt annual renal function testing. PMID: 26913911 [PubMed - as supplied by publisher] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - February 26, 2016 Category: Journals (General) Tags: N Z Med J Source Type: research

The impact of joint consultation with family physicians on perception of psychologists.
Evidence in the literature indicates that psychology is regarded favorably. The public, however, appears somewhat confused about the role and functions of psychologists. This may impact upon the capacity of professionals to assist the wider community. The aim of this study was to investigate whether the presence of a psychologist in the primary care setting together with the physician affects the image of psychologists among the public. An observational study was conducted on a group of 227 patients recruited in the waiting rooms of 4 primary care practices: the physician worked in a joint consultation with the psychologis...
Source: Professional Psychology: Research and Practice - February 25, 2016 Category: Psychiatry & Psychology Authors: Cordella, Barbara; Greco, Francesca; Di Trani, Michela; Renzi, Alessia; La Corte, Cosima; Solano, Luigi Source Type: research

Patient, Physician, Medical Assistant, and Office Visit Factors Associated With Medication List Agreement
Conclusions: Having MAs begin their medication review with an open-ended question may be a simple, inexpensive, and easily implemented process to increase accuracy of medication lists for prescription and nonprescription medications. (Source: Journal of Patient Safety)
Source: Journal of Patient Safety - February 24, 2016 Category: Health Management Tags: Original Articles Source Type: research

Shared decision making in endocrinology: present and future directions
Publication date: Available online 23 February 2016 Source:The Lancet Diabetes & Endocrinology Author(s): Rene Rodriguez-Gutierrez, Michael R Gionfriddo, Naykky Singh Ospina, Spyridoula Maraka, Shrikant Tamhane, Victor M Montori, Juan P Brito In medicine and endocrinology, there are few clinical circumstances in which clinicians can accurately predict what is best for their patients. As a result, patients and clinicians frequently have to make decisions about which there is uncertainty. Uncertainty results from limitations in the research evidence, unclear patient preferences, or an inability to predict ho...
Source: The Lancet Diabetes and Endocrinology - February 23, 2016 Category: Endocrinology Source Type: research

Child Suicide Screening Methods: Are We Asking the Right Questions? A Review of the Literature and Recommendations for Practice
Few suicide screening instruments are specifically designed for the 5 to 14 year-old age group. This paper reviews five currently available suicide screening tools that might be appropriate for use with children, evaluates the quality of these tools, and recommends which tools might be useful in primary care practice. To detect and prevent child suicide, primary care nurse practitioners must be committed to child-centered care, recognize that suicidal thoughts and behaviors can develop early in life, identify pertinent state and trait risk factors in children, have knowledge about the quality of available screening tools, ...
Source: The Journal for Nurse Practitioners - February 23, 2016 Category: Nursing Authors: Arwen York, Barbara Heise, Brandon Thatcher Tags: Featured Article Source Type: research

Inequalities in the uptake of weight management interventions in a pragmatic trial: an observational study in primary care.
CONCLUSION: Males, younger people, and those from more deprived areas were less likely to take up the invitation to participate in this trial. The gender bias was smaller than observed in routine practice, suggesting that a substantial proportion of the inequity observed previously is a consequence of bias with regard to the offer of intervention. This study suggests that a simple way to overcome much of the gender bias is to write to patients who are overweight and offer referral. Uptake of the invitation to participate was lower in groups of lower socioeconomic status suggesting the need to preferentially offer referrals...
Source: The British Journal of General Practice - February 23, 2016 Category: Primary Care Authors: Ahern AL, Aveyard P, Boyland EJ, Halford JC, Jebb SA, WRAP trial team Tags: Br J Gen Pract Source Type: research

Successful Implementation of HIV Preexposure Prophylaxis: Lessons Learned From Three Clinical Settings
Abstract The past 3 years have marked a transition from research establishing the safety and efficacy of HIV preexposure prophylaxis (PrEP) to questions about how to optimize its implementation. Until recently, PrEP was primarily offered as part of randomized controlled trials or open-label studies. These studies highlighted the key components of PrEP delivery, including regular testing for HIV and other sexually transmitted infections (STIs), adherence and risk-reduction support, and monitoring for renal toxicity. PrEP is now increasingly provided in routine clinical settings. This review summarizes models f...
Source: Current HIV/AIDS Reports - February 22, 2016 Category: Infectious Diseases Source Type: research

AHJ paperImpact of an Atrial Fibrillation Decision Support Tool (AFDST) on Thromboprophylaxis for Atrial Fibrillation
Conclusions Among patients whose physicians reviewed recommendations of the decision support tool discordant therapy decreased significantly over 1 year. However, in non-stratified analyses the intervention did not result in significant improvements in discordant antithrombotic therapy. (Source: American Heart Journal)
Source: American Heart Journal - February 20, 2016 Category: Cardiology Source Type: research

Improving Chlamydia Screening Rates at an Urban Primary Care Clinic
Our objective was to increase by 10% routine chlamydia (CT) screening rates of sexually active females aged 15-19 by primary care providers at an urban pediatric and adolescent clinic by May 2015. The CDC, ACOG, and AAP recommend routine annual CT screening for sexually active adolescent females. CT screening programs can lead to up to a 60% reduction in the incidence of PID. A prior study demonstrated that only 2.6% of adolescent patients seen for well visits at all 29 pediatric primary care practices affiliated with our children’s hospital had been screened in the prior year. (Source: Journal of Pediatric and Adolescent Gynecology)
Source: Journal of Pediatric and Adolescent Gynecology - February 19, 2016 Category: OBGYN Authors: Cherie Priya Dhar, Caroline Salas-Humara, Kenisha Campbell Source Type: research

Fracture risk in patients with type 2 diabetes under different antidiabetic treatment regimens: a retrospective database analysis in primary care
Conclusion: Long-standing therapy with insulin glargine was associated with a lower odds of having any fractures compared to NPH insulin. Further studies are required to investigate whether the lower chance is due to a reduced frequency of hypoglycemia. Keywords: type 2 diabetes, fracture risk, insulin treatment, oral antidiabetic medication, primary care (Source: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy)
Source: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy - February 19, 2016 Category: Endocrinology Tags: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Source Type: research

Improving Pediatric Asthma Care: A Partnership between Pediatric Primary Care Clinics and a Free-Standing Children's Hospital.
Authors: Sheikh SI, Chrysler M, Ryan-Wenger NA, Hayes D, McCoy KS Abstract BACKGROUND: Asthma is a common chronic disease of childhood. Providers' adherence to asthma guidelines is still less than optimal. OBJECTIVES: To determine if an Asthma Education Program aimed at primary care practices can improve asthma care within practices and if the results vary by duration of the program. METHODS: Ten practices were randomly assigned to an Early Asthma Education Intervention (EI) group or a Delayed Asthma Education Intervention (DI) group. The EI group received the intervention for 12 months and was monitored fo...
Source: Journal of Asthma - February 18, 2016 Category: Respiratory Medicine Tags: J Asthma Source Type: research

Forthcoming Issues
Psychiatric Care in the Primary Care Practice (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - February 18, 2016 Category: Primary Care Source Type: research

Swimming 'upstream to tackle the social determinants of health
Quality improvement interventions typically focus on how to improve the care delivered within healthcare organisations or by health systems. Rarely do efforts venture beyond the walls of clinics and hospitals to target the social determinants of health. Berkowitz et al1 remind us that swimming ‘upstream’ is essential if we want to improve health outcomes for vulnerable or disadvantaged patients. The authors conducted a cross-sectional study of a Health Leads intervention in two urban adult primary care practices. Social needs were identified and then addressed by advocates based in the practices. They found tha...
Source: BMJ Quality and Safety - February 18, 2016 Category: Journals (General) Authors: Kiran, T., Pinto, A. D. Tags: BMJQS Noteworthy articles Editorials Source Type: research

“It All Depends”: A Qualitative Study of Parents’ Views of Human Papillomavirus Vaccine for their Adolescents at Ages 11–12 years
Abstract Routine vaccination with three doses of human papillomavirus (HPV) vaccine is recommended for adolescent girls and boys at 11 or 12 years of age; however, vaccine uptake remains suboptimal. To understand the reasons why parents may accept or refuse HPV vaccine for their children at age 11 or 12 years, we conducted a qualitative study. Semi-structured interviews were conducted with parents or guardians (n = 45) whose adolescents receive care at an urban, hospital-based primary care practice. Data were analyzed using an iterative thematic approach. We found that many parents express...
Source: Journal of Cancer Education - February 17, 2016 Category: Cancer & Oncology Source Type: research

Personalized prevention approach with use of a web-based cardiovascular risk assessment with tailored lifestyle follow-up in primary care practice - a pilot study
Conclusions The personalized prevention approach offers a system for integrated risk profiling and individualized health management that was well received in general practice. The client-centred approach, which was embedded in a local community setting, using a web-based health risk assessment with tailored feedback and linkage to regional health management and lifestyle providers proved feasible, and successful. Participating in the health risk assessment elicited actual behaviour change among follow-up survey respondents. (Source: European Journal of Preventive Cardiology)
Source: European Journal of Preventive Cardiology - February 16, 2016 Category: Cardiology Authors: van den Brekel-Dijkstra, K., Rengers, A. H., Niessen, M. A., de Wit, N. J., Kraaijenhagen, R. A. Tags: Original scientific paper Source Type: research

Protocol for the rural engagement in Primary Care for optimizing weight reduction (RE-POWER) trial: Comparing three obesity treatment models in rural primary care
The objective of this cluster-randomized pragmatic trial is to evaluate the comparative effectiveness of three obesity treatment models in rural primary care: the Intensive Behavior Therapy fee-for-service (FFS) model reimbursed by Medicare, a team-based model that recognizes the patient-centered medical home (PCMH) as a preferred delivery approach, and the centralized disease management (DM) model, in which phone-based counseling is provided outside of with the primary care practice. (Source: Contemporary Clinical Trials)
Source: Contemporary Clinical Trials - February 16, 2016 Category: Radiology Authors: Christie A. Befort, Jeffrey J. VanWormer, Cyrus DeSouza, Edward F. Ellerbeck, Kim S. Kimminau, Allen Greiner, Byron Gajewski, Terry Huang, Michael G. Perri, Tera L. Fazzino, Danielle Christifano, Leslie Eiland, Andjela Drincic Source Type: research

Information practices of health care professionals related to patient discharge from hospital.
CONCLUSION: Hospital routines and professional norms prescribing that discharge information should take place in parallel processes by hospital physicians and by nurses impede transparency and interdisciplinary coordination in primary care. A strong focus on providing patients only with information that is tailored for them neglects the interest patients may have in seeing what information about them is transmitted to primary care. PRACTICE IMPLICATIONS: Hospital routines and professional culture are important factors to consider in efforts to promote more transparent health care for patients and improved interdiscipli...
Source: Informatics for Health and Social Care - February 14, 2016 Category: Information Technology Tags: Inform Health Soc Care Source Type: research

Prescribing patterns for upper respiratory tract infections: a prescription-review of primary care practice in Kedah, Malaysia, and the implications.
CONCLUSIONS: Prescribing practices of some prescribers were inconsistent with current guidelines encouraging resistance development. National antimicrobial stewardship programs and further educational initiatives are ongoing in Malaysia to improve antibiotic use. PMID: 26358203 [PubMed - in process] (Source: Expert Review of Anti-Infective Therapy)
Source: Expert Review of Anti-Infective Therapy - February 14, 2016 Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research

Screening for Celiac Disease in a Pediatric Primary Care Setting
Celiac disease (CD) is an autoimmune enteropathy in genetically predisposed individuals triggered by the ingestion of gluten. The prevalence in adults in the United States is increasing. Despite recognition of asymptomatic patients that benefit from screening and improved diagnostics, the majority of patients remain undiagnosed. The purpose of this study is to determine the prevalence of CD in at-risk and not-at-risk pediatric patients in a primary care practice routinely screening for CD. The records of 2325 pediatric patients who underwent serological testing with immunoglobulin A tissue transglutaminase (tTG) during a 5...
Source: Clinical Pediatrics - February 10, 2016 Category: Pediatrics Authors: Leonard, M. M., Fogle, R., Asch, A., Katz, A. Tags: Articles Source Type: research

Identifying Social Determinants of Health and Legal Needs for Children With Special Health Care Needs
Children with special health care needs (CSHCN) require comprehensive care with high levels of community and government assistance. Medical–legal partnerships may be particularly suited to address needs for this population. To explore this, we conducted in-depth telephone interviews of families of CSHCN cared for in the primary care practice of our tertiary care children’s hospital. The majority of the sample (N = 46) had been late on housing payments and 17% of homeowners had been threatened with foreclosure. Families frequently reported denial of public benefits. Approximately 10% had executed advance plannin...
Source: Clinical Pediatrics - February 10, 2016 Category: Pediatrics Authors: DeJong, N. A., Wood, C. T., Morreale, M. C., Ellis, C., Davis, D., Fernandez, J., Steiner, M. J. Tags: Articles Source Type: research

Medical Assistant-Based Care Management for High-Risk Patients in Small Primary Care Practices: A Cluster Randomized Clinical Trial.
Conclusion: This low-intensity intervention did not reduce all-cause hospitalizations but showed positive effects on quality of life at reasonable costs in high-risk multimorbid patients. Primary Funding Source: AOK Baden-Württemberg and AOK Bundesverband. PMID: 26833209 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - February 2, 2016 Category: Internal Medicine Authors: Freund T, Peters-Klimm F, Boyd CM, Mahler C, Gensichen J, Erler A, Beyer M, Gondan M, Rochon J, Gerlach FM, Szecsenyi J Tags: Ann Intern Med Source Type: research

The impact of behavioral and mental health risk assessments on goal setting in primary care
Abstract Patient-centered health risk assessments (HRAs) that screen for unhealthy behaviors, prioritize concerns, and provide feedback may improve counseling, goal setting, and health. To evaluate the effectiveness of routinely administering a patient-centered HRA, My Own Health Report, for diet, exercise, smoking, alcohol, drug use, stress, depression, anxiety, and sleep, 18 primary care practices were randomized to ask patients to complete My Own Health Report (MOHR) before an office visit (intervention) or continue usual care (control). Intervention practice patients were more likely than control practice pati...
Source: Translational Behavioral Medicine - February 2, 2016 Category: Global & Universal Source Type: research

Validation of the Behavioral Health Checklist in Diverse Pediatric Primary Care Settings
Conclusion: The BHCL was demonstrated to have strong construct and predictive validity. The predictive validity of each version was demonstrated across genders, socioeconomic status, and racial groups (black or African American and white). The BHCL has promise as a developmentally and culturally effective behavioral health screener for use in pediatric primary care practices. (Source: Journal of Developmental and Behavioral Pediatrics)
Source: Journal of Developmental and Behavioral Pediatrics - February 1, 2016 Category: Child Development Tags: Original Articles Source Type: research

Serum testosterone, testosterone replacement therapy and all‐cause mortality in men with type 2 diabetes: retrospective consideration of the impact of PDE5 inhibitors and statins
ConclusionsTestosterone replacement therapy is independently associated with reduced mortality in men with T2DM. PDE5I use, included as a confounding factor, was associated with decreased mortality in all patients and, those not on TRT, suggesting independence of effect. The impact of PDE5I treatment on mortality (both HR and OR
Source: International Journal of Clinical Practice - February 1, 2016 Category: Internal Medicine Authors: G. Hackett, A. H. Heald, A. Sinclair, P. W. Jones, R. C. Strange, S. Ramachandran Tags: Original Paper Source Type: research

Primary Care Physician‐Pharmacist Collaborative Care Model: Strategies for Implementation
This article is protected by copyright. All rights reserved. (Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy)
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - February 1, 2016 Category: Drugs & Pharmacology Authors: Barry L. Carter Tags: Invited Commentary Source Type: research

Recruiting Quarterbacks: Strategies for Revitalizing Training in Primary Care Internal Medicine
Current U.S. primary care workforce shortages and trainees’ declining interest in primary care residency training, especially regarding primary care internal medicine, have many parallels with circumstances in the early 1970s, when modern adult primary care first emerged. Rediscovery of the lessons learned and the solutions developed at that time and applying them to the current situation have the potential to help engage a new generation of young physicians in the primary care mission. The author compares the internal medicine residency primary care track at the University of New Mexico, described by Brislen and co...
Source: Academic Medicine - January 29, 2016 Category: Universities & Medical Training Tags: Commentaries Source Type: research

Challenges in interdisciplinary weight management in primary care: lessons learned from the 5As Team study
Summary Increasingly, research is directed at advancing methods to address obesity management in primary care. In this paper we describe the role of interdisciplinary collaboration, or lack thereof, in patient weight management within 12 teams in a large primary care network in Alberta, Canada. Qualitative data for the present analysis were derived from the 5As Team (5AsT) trial, a mixed‐method randomized control trial of a 6‐month participatory, team‐based educational intervention aimed at improving the quality and quantity of obesity management encounters in primary care practice. Participants (n = 29...
Source: Clinical Obesity - January 27, 2016 Category: Eating Disorders and Weight Management Authors: J. Asselin, A. M. Osunlana, A. A. Ogunleye, A. M. Sharma, D. Campbell‐Scherer Tags: Original Article Source Type: research

Recommendations for Screening for Depression in Adults
Although major depressive disorder (MDD) is one of the world’s great public health problems, the morbidity and increased mortality associated with this common illness can be attenuated by the large number of effective treatments that are now widely available. It is therefore important to ensure that efficient methods for population screening are in place and directly linked to health care systems so depressed patients receive appropriate treatment. This is particularly important because effective treatments of depression not only reduce symptoms associated with the disease and reduce the risk of suicide, but also can...
Source: JAMA - January 26, 2016 Category: Journals (General) Source Type: research

Improving CT Screening Rates at an Urban Primary Care Clinic
Our objective was to increase by 10% routine chlamydia (CT) screening rates of sexually active females aged 15-19 by primary care providers at an urban pediatric and adolescent clinic by May 2015. The CDC, ACOG, and AAP recommend routine annual CT screening for sexually active adolescent females. CT screening programs can lead to up to a 60% reduction in the incidence of PID. A prior study demonstrated that only 2.6% of adolescent patients seen for well visits at all 29 pediatric primary care practices affiliated with our children’s hospital had been screened in the prior year. (Source: Journal of Adolescent Health)
Source: Journal of Adolescent Health - January 23, 2016 Category: Child Development Authors: Cherie Priya Dhar, Caroline Salas-Humara, Kenisha Campbell Tags: Poster Session II: Quality Improvement Source Type: research